Ecology in the Pre-medical Curriculum

Background

Scientific Foundations for Future Physicians, a 2009 report of the Association of American Medical Colleges (AAMC) and the Howard Hughes Medical Institute (HHMI), proposes eight core competencies that pre-medical students should fulfill in their undergraduate education, as an alternative to the traditional required courses in the pre-medical curriculum. More recently, changes have been proposed for the MCAT to reflect this shift to core competencies. Despite the positive change toward core competencies, the proposed competencies largely ignore the importance of evolutionary biology, biodiversity, ecology, and environmental science in the pre-medical and medical curriculum.

In the AAMC-HHMI report, evolutionary biology is included to a limited degree in the pre-medical core competencies (Competency E8). In addition, the report includes ecological principles in the competencies for the medical curriculum (Competency M6), such as:

 

• "Apply the principles of host–pathogen and pathogen–population interactions and knowledge of pathogen structure, genomics, life-cycle, transmission, natural history, and pathogenesis to the prevention, diagnosis, and treatment of infectious disease."
• "Apply the principles of symbiosis (commensalisms, mutualism, and parasitism) to the maintenance of health and disease."

 

However, these ecological principles are not reflected in the pre-medical competencies.

 

What's New? "Add Ecology to the Pre-Medical Curriculum," a letter initiated by members of EHRC and led by Dr. Chris Beck of Emory University in response to MCAT changes. Dr. Chris Beck, et al. 2012. Add Ecology to the Pre-Medical Curriculum. Science: 1301. Science: 1301. doi: http://dx.doi.org/10.1126/science.335.6074.1301-a.

 

Proposed Core Competency on Ecological Principles and Biodiversity for The Pre-Medical Curriculum

Competency: Demonstrate an understanding of taxonomic diversity and fundamental ecological processes and how they relate to human health.

1. Discuss the features of the major phyla of plants, animals and microbes.

Examples:

• Explain how bacteria differ from viruses and protozoans.
• Discuss the features that are common to parasitic worms, and distinguish them from free-living taxa.
• Provide an example of a pharmacologically active secondary metabolite that is unique to a single plant family.
  

 

2. Discuss concepts of population growth and regulation.

Examples:

• Explain how the population dynamics of a vector will influence disease transmission in a vector-borne disease.
• Explain the concept of carrying capacity and whether it is applicable to all species.

 

3. Discuss the outcomes of species interactions.

Examples:

• Define biodiversity and know how it relates to the prevalence of diseases like Lyme disease.
• Explain how host-parasite dynamics differ from other species interactions.

 

4. Demonstrate an understanding of the impacts that humans have had on ecosystem processes and the importance of those processes.

Examples:

• Explain what is meant by global climate change and how its consequences can impact human health.
• Explain the concept of ecological services from the standpoint of improving water and air quality.
• Compare the ecological correlates of disease transmission for people living in urban, suburban, and rural locations.

References

Scientific Foundations for Future Physicians, "Report of the AAMC-HHMI Committee" (AAMC, Washington, DC, 2009); www.hhmi.org/grants/pdf/08-209_AAMC-HHMI_report.pdf.

AAMC, "5th Comprehensive Review of the Medical College Admission Test® (MCAT)" (www.aamc.org/download/182662/data/mr5_preliminary_recommendations.pdf).

Other Resources

Frontiers in Ecology and the Environment

Kathleen A Alexander, and J Weldon McNutt. 2010. Human behavior influences infectious disease emergence at the human–animal interface. Frontiers in Ecology and the Environment 8: 522–526. doi:http://dx.doi.org/10.1890/090057

Katherine F. Smith, Andrew P. Dobson, F Ellis McKenzie, Leslie A. Real, David L. Smith, and Mark L. Wilson. 2005. Ecological theory to enhance infectious disease control and public health policy. Frontiers in Ecology and the Environment 3: 29–37. doi:http://dx.doi.org/10.1890/1540-9295(2005)003[0029:ETTEID]2.0.CO;2

Courtney Richmond, Diane Ebert-May, and Janet Hodder. 2005. Lyme disease: a case about ecosystem services. Frontiers in Ecology and the Environment 3: 557–558. doi:http://dx.doi.org/10.1890/1540-9295(2005)003[0557:LDACAE]2.0.CO;2

Richard S. Ostfeld, and Robert D. Holt. 2004. Are predators good for your health? Evaluating evidence for top-down regulation of zoonotic disease reservoirs. Frontiers in Ecology and the Environment 2: 13–20. doi:http://dx.doi.org/10.1890/1540-9295(2004)002[0013:APGFYH]2.0.CO;2

Julie E Helson, Todd L Capson, Timothy Johns, Annette Aiello, and Donald M Windsor. 2009. Ecological and evolutionary bioprospecting: using aposematic insects as guides to rainforest plants active against disease. Frontiers in Ecology and the Environment 7: 130–134. doi:http://dx.doi.org/10.1890/070189

Richard W. Merritt, M Eric Benbow, and Pamela LC Small. 2005. Unraveling an emerging disease associated with disturbed aquatic environments: the case of Buruli ulcer. Frontiers in Ecology and the Environment 3: 323–331. doi:http://dx.doi.org/10.1890/1540-9295(2005)003[0323:UAEDAW]2.0.CO;2

Todd A Crowl, Thomas O Crist, Robert R Parmenter, Gary Belovsky, and Ariel E Lugo. 2008. The spread of invasive species and infectious disease as drivers of ecosystem change. Frontiers in Ecology and the Environment 6: 238–246. doi:http://dx.doi.org/10.1890/070151

Sara H Paull, Sejin Song, Katherine M McClure, Loren C Sackett, A Marm Kilpatrick, and Pieter TJ Johnson. 2011. From superspreaders to disease hotspots: linking transmission across hosts and space. Frontiers in Ecology and the Environment (e-View) doi:http://dx.doi.org/10.1890/110111

Alan R. Townsend, Robert W. Howarth, Fakhri A. Bazzaz, Mary S. Booth, Cory C. Cleveland, Sharon K. Collinge, Andrew P. Dobson, Paul R. Epstein, Elisabeth A. Holland, Dennis R. Keeney, Michael A. Mallin, Christine A. Rogers, Peter Wayne, and Amir H. Wolfe. 2003. Human health effects of a changing global nitrogen cycle. Frontiers in Ecology and the Environment 1: 240–246. doi:http://dx.doi.org/10.1890/1540-9295(2003)001[0240:HHEOAC]2.0.CO;2

Phyllis D. Coley, Maria V. Heller, Rafael Aizprua, Blanca Araúz, Nayda Flores, Mireya Correa, Mahabir Gupta, Pablo N. Solis, Eduardo Ortega-Barría, Luz I. Romero, Basilio Gómez, Marla Ramos, Luis Cubilla-Rios, Todd L. Capson, and Thomas A. Kursar. 2003. Using ecological criteria to design plant collection strategies for drug discovery. Frontiers in Ecology and the Environment 1: 421–428. doi:http://dx.doi.org/10.1890/1540-9295(2003)001[0421:UECTDP]2.0.CO;2

Meredith A Barrett, Timothy A Bouley, Aaron H Stoertz, and Rosemary W Stoertz. 2011. Integrating a One Health approach in education to address global health and sustainability challenges. Frontiers in Ecology and the Environment 9: 239–245. doi:http://dx.doi.org/10.1890/090159

R Jory Brinkerhoff, Corrine M Folsom-O'Keefe, Kimberly Tsao, and Maria A Diuk-Wasser. 2011. Do birds affect Lyme disease risk? Range expansion of the vector-borne pathogen Borrelia burgdorferi. Frontiers in Ecology and the Environment 9: 103–110. doi:http://dx.doi.org/10.1890/090062

Nils Chr Stenseth, Herwig Leirs, Anders Skonhoft, Stephen A. Davis, Roger P. Pech, Harry P. Andreassen, Grant R. Singleton, Mauricio Lima, Robert S. Machang’u, Rhodes H. Makundi, Zhibin Zhang, Peter R. Brown, Dazhao Shi, and Xinrong Wan. 2003. Mice, rats, and people: the bio-economics of agricultural rodent pests. Frontiers in Ecology and the Environment 1: 367–375. doi:http://dx.doi.org/10.1890/1540-9295(2003)001[0367:MRAPTB]2.0.CO;2

Katherine Ellison. 2009. Toxins and toddlers. Frontiers in Ecology and the Environment 7: 228. doi:http://dx.doi.org/10.1890/1540-9295-7.4.228

Journal Articles

David J. Newman and Gordon M. Cragg. 2007. Natural Products as Sources of New Drugs over the Last 25 Years. J. Nat. Prod. 70:461–477. doi:http://dx.doi.org/ 10.1021/np068054v

Aaron S. Bernstein and David S. Ludwig. 2008. The Importance of Biodiversity to Medicine. Journal of American Medical Association 300:2297-2299. doi:http://dx.doi.org/10.1001/jama.2008.655

Books

Eric Chivian and Aaron Bernstein, eds. 2008. Sustaining Life: How Human Health Depends on Biodiversity. Oxford University Press.

 

Letters

Dr. Chris Beck, et al. 2012. Add Ecology to the Pre-Medical Curriculum. Science: 1301. doi: http://dx.doi.org/10.1126/science.335.6074.1301-a

 

Websites

One Health Initiative – an initiative to examine the relationship between animal and human health (http://www.onehealthinitiative.com/)

EcoHealth – the International Association for Ecology and Health (http://www.ecohealth.net/)